Individual
MACKENZIE COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-1230
(843) 852-4100
Mailing address
3710 RADDISON LN, LADSON, SC 29456
(812) 499-1953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
12292
SC
104100000X
Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
07/06/2012
Last updated
04/03/2019
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